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About Workers Comp Benefits

Workers’ Compensation Benefits in Los Angeles, CA

Benefits for Injured Workers

Workers’ compensation is a type of insurance system that provides benefits and medical treatment for workers who are injured at work or fall ill as a result of occupational exposure or the duties associated with their jobs. In California, an injured worker or his or her family may be entitled to specific benefits under the state’s workers’ compensation system. It is important to understand exactly what benefits may apply so you can approach your claim and seek the financial support and medical treatment you deserve. In addition to reviewing the information included here, please feel free to call a Los Angeles workers’ compensation lawyer at our firm for a free consultation.

Medical Care An injured worker is entitled to medical treatment that is required to recover from a work-related illness or injury. This may include hospitalization, doctor visits, medication, medical equipment, diagnostic and other tests, and even travel costs to and from medical appointments.

Temporary Disability Benefits A worker is also entitled to cash benefits to make up for wages lost while injured or ill and unable to work – if the condition is work-related. For a temporary disability, these payments are paid while the worker is recovering. Temporary total disability benefits may be paid for the duration of the worker’s disability, ranging from $160 to $1,066.72 per week (as of 2013) depending on the worker’s average weekly wage.

Permanent Disability Benefits If a worker is permanently disabled, he or she may be entitled to benefits. This applies if the worker suffers from a permanent physical or mental condition that impacts normal functions and/or his or her ability to be gainfully employed. Depending on the extent of disability and the part of the body, a worker may be entitled to a lump sum payment.

Supplemental Job Displacement Benefits If a worker is eligible for permanent disability benefits and is unable to return to work for his or her previous employer, he or she may be entitled to a voucher that will help pay for retaining or skill enhancement to enter a new field or position. The maximum benefit is $6,000 (as of 2013) and this amount will vary depending on the condition.

Death Benefits If a worker loses his or her life as a result of an on-the-job injury or occupational illness, the family may be entitled to death benefits, which may include money for the deceased worker’s lost earnings and burial expenses.

Los Angeles Workers’ Compensation Attorney

There are a number of factors that may influence the specific weekly benefits and/or lump sum payment to which an injured worker is entitled. For this reason, you may find it helpful to involve an attorney who can advise you of your rights and the benefits allowed by law. You can also rely on an attorney to represent your interests if your claim is disputed or denied by a claims administrator.

At Pacific Attorney Group, we represent workers and their families in workers’ compensation claims, hearings and appeals across the greater Los Angeles area. We realize how complicated workers’ comp proceedings can be and are committed to the preservation of injured workers’ rights in these matters. To learn more about our firm and how we can help you, contact our offices. We offer a free case review.

Denied Workers’ Compensation Claims

Los Angeles Workers’ Comp Attorney

Not all workers’ compensation claims are approved, and if you received a letter from the claims administrator that your claim was denied, you can take several steps to dispute this denial. There are deadlines by which you must file the necessary paperwork, however, so it is important to act quickly. You may also wish to involve an attorney. Though you can represent yourself in these proceedings, having a legal professional may work to your favor in presenting a clear and compelling case.

Pacific Attorney Group offers a free initial consultation to discuss your denied workers’ compensation claim. Our Los Angeles workers’ comp attorneys have decades of experience in representing injured workers even in the most complex of claims and we are prepared to put our knowledge to work for you. In every case we handle, we strive to seek an approval and just benefits that will help our client face a better and more stable future. You can find out more about appealing a denied claim by contacting our offices, or you can review the information included below.

Contesting a Denied Workers’ Comp Claim

In California, contesting a denied workers’ compensation claim is done by filing a case at one of the 24 local Division of Workers’ Compensation (DWC) offices located across the state. This is the general process by which a denial may be contested:

You will need to fill out and file an Application for Adjudication of Claim with the office located in your county or the county in which you were injured. This application must also be served on any relevant parties, which typically includes the claims administrator.

Next, the DWC office where you filed your application will send you a notice that this has been received. You will be assigned a case number, which you will need to use in any and all correspondence related to your claim.

If you want to request a hearing before a judge, you will need to file a Declaration of Readiness to Proceed. This lets the DWC know that you are ready for a hearing, called a mandatory settlement conference, in front of a workers’ compensation administrative law judge.

After filing a Declaration of Readiness to Proceed, a hearing will be scheduled for a judge to hear your case.

At the hearing, you (and your attorney, if you have one) and the claims administrator (and/or their attorney) must appear before the judge. The judge will try to help you reach an agreement by discussing the case with you, using the facts and evidence at hand. If your case cannot be settled in this manner, it will be sent to trial.

A trial will be held in front of another judge, who will consider the evidence and information provided by both parties to reach a decision on your claim. The judge will then issue a written decision on the matter and mail this to you between 30 and 90 days after the trial.

If your claim is still not approved, you have the option to file a Petition for Reconsideration. This is essentially an appeal of the judge’s decision, sent to the Workers’ Compensation Appeals Board. The Board may uphold or reverse the judge’s decision or may send the case back for another trial.

It is not easy to receive a notice that your workers’ compensation claim has been denied, but it is important to remember that you have options. A denial does not mean your case is over. With a Los Angeles workers’ compensation lawyer from our firm to help you seek a hearing and even file an appeal, you can seek a positive result. Call our offices today for a free review of your case.

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